Department of internal medicine, Oskarshamn hospital, Oskarshamn, Sweden.
BMC Gastroenterol. 2013 Jul 10;13:111. doi: 10.1186/1471-230X-13-111.
Evaluation of intraepithelial duodenal lymphocytosis (IDL) is important in celiac disease (CD). There is no established cut-off value for increased number of IELs in the bulb.We therefore investigated the relation between IEL counts in the bulb and duodenal specimens in non-celiac subjects.
The number of CD3+ IELs was determined in specimens from the second part of the duodenum and from the bulb in 34 non-celiac subjects. The numbers of IELs in the villus tip and sides were counted and the quotient tip/side was calculated. HLA DQ2/DQ8 and serum antibodies against transglutaminase were analysed.
The mean number of IELs per 100 enterocytes (95% CI) in specimens was 14.7 (11.8-17.6) in the bulb, and 21.2 (17.0-25.5) in the second part of the duodenum (p<0.01). There was no difference in IEL count or distribution comparing patients carrying or lacking HLA DQ2/DQ8.
IEL count in non-celiac, HLA DQ2/DQ8 positive or negative patients is significantly lower in the bulb than in the second part of the duodenum. These findings implicate that the site of biopsy should be taken into account when considering duodenal lymphocytosis.
肠上皮内固有层淋巴细胞（IDL）的评估在乳糜泻（CD）中很重要。在球部，没有确定 IDL 增加的明确界限值。因此，我们研究了非乳糜泻患者球部和十二指肠标本中 IDL 计数之间的关系。
在 34 名非乳糜泻患者的十二指肠第二部分和球部标本中测定 CD3+ IDL 计数。计算绒毛尖端和侧面的 IDL 数量，并计算尖端/侧面的商。分析 HLA DQ2/DQ8 和抗转谷氨酰胺酶抗体。
球部每 100 个肠上皮细胞的 IDL 平均数（95%CI）为 14.7（11.8-17.6），十二指肠第二部分为 21.2（17.0-25.5）（p<0.01）。携带或缺乏 HLA DQ2/DQ8 的患者 IDL 计数或分布无差异。
非乳糜泻、HLA DQ2/DQ8 阳性或阴性患者的球部 IDL 计数明显低于十二指肠第二部分。这些发现表明，在考虑 IDL 增加时，应考虑活检部位。
